​As an expert in the areas of healthcare risk management and healthcare culture, I have spent a great deal of my career focusing on disruptive behaviors and their impact on patient safety, patient care, and the culture in work settings. The impacts are far reaching, pervasive, and insidious to all those involved. As a result of the attention paid to the role disruptive behavior play in outcomes, as well as the role social media sites such as Yelp and Doctors.com have on the perceptions of healthcare providers and institutions to the public, malpractice litigation is beginning to look at how a lack of a culture of safety program and accountability contributes to a plaintiff verdict.

Plaintiff attorneys are beginning to look at these disruptive behaviors and how they are directed towards both patients and colleagues, how they impact communication, clinical care, and fosters a culture that could have a foreseeable impact on patient safety, likely resulting in an increased risk of morbidity or mortality on vulnerable patient populations. Additionally, attorneys and credentialing bodies are beginning to use social media opinion sites to access provider risk to the institution. Though these sites are subjective in nature, these types of unsolicited complaints can be both enlightening and salacious, providing for “sound bites” for litigation purposes.

When you review depositions and unsolicited online reviews that involve disruptive providers, it is clear that the behavior, and inherent patient safety risks therein, should have been well known to supervisors, medical and administrative staff, and the affiliated institutions. What is normally seen is a lack of clear response that that any of these groups  identified or acknowledged them and fail to realize that addressing disruptive behaviors is a cornerstone of establishing trust with patients and the work-force. It is also unclear whether these groups acknowledged the importance of online complaints filed against physicians as part of the credentialing process. As a result, there does not appear to be an adequate response system in place by the institutions or medical staff leadership to address disruptive behaviors when concerns arise. There is often a lack of evidence of even a minimal programming that would be expected to receive, investigate, and respond to disruptive behavior, which includes: (1) alert/reporting process, (2) review by Risk Management or Medical Staff for egregious nature of behavior and trending of behaviors, (3) review by authority figure, (4) appropriate counseling or discipline by an authority figure, and (5) peer-review actions or sanctions for egregious or trended behaviors.

Consultingservices include current state analysis, programming, and implementation of programs for:

• ​Organizational Assessment and Strategic Planning
  
• Using the Principles of Authority, Visibility, Communication, Coordination, and Accountability to engender ​Trust
  
• Healthcare Culture and Professionalism Education and Programming
  
• Team Communication and Interpersonal Engagement 
  
• Emotional Support of Employees 
  
• Addressing Regulatory and Accreditation Expectations
• Social Media and eCommunication 
  

Culture of Safety and Professionalism  Consultation Services